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Monday, September 12, 2011

ectopic

Below is an email I wrote to a friend soon after my ectopic.  She experienced an ectopic pregnancy as well and I had a friend I could go to with questions, thoughts, and a shared experience. 

April 28, 2011
Physically, I am feeling stronger each day, but emotionally, I feel like I'm on a roller coaster ride.  As we grieve, we're leaning on the Lord for his comfort, strength and peace that surpasses all understanding. I wanted to share more details with you that I didn't share on the home group site. 

Monday afternoon (my birthday), I experienced the worst pain imaginable.  I took some medicine and it helped take the pain away.  When James came home from work, he took me to Abington Hospital.  The resident doctor did some blood work and informed us that we were pregnant.  My pregnancy hormone was 760!  I never reached that level before and was in complete shock since we were on a break from trying to conceive.  I took a bed ride to get a pelvic and internal ultrasound to find out the location of the baby.  I asked the tech if she saw anything and said that she didn't see anything in my uterus.  After hearing those words, I didn't ask anymore questions.  Once I was rolled back to my room, things moved very quickly.  They told me I had an ectopic pregnancy, I needed emergency surgery,  and had me sign a consent form just in case I needed a blood transfusion.   During my stay, a couple things happened which made me nervous about the night shift staff, but once I met my surgeon, she put me to ease and I finally felt like I was in capable hands.

I entered the operating room around 1:30-2 am and the surgery took 1-1.5 hours.  The nurses woke me up from surgery and I said, "I just played with my kids in heaven".  One nurse said, "Aww, did you hear that?" and the other nurse replied, "yes".  I honestly can't remember any details, but those were the first words out of my dry mouth.  I couldn't open my eyes because they were glued shut by dried tears and swollen eyes, but I could hear the nurses talking to me and their voices sounded familiar to me...one nurse had the voice of a friend from work and the other nurse sounded like a friend from griefshare.  The dream and familiar voices were comforting to me.

After sleeping for an hour or so, the doctor came in and showed me some amazing pictures of the surgery.   It turns out that I had a ruptured ectopic pregnancy.  The doctor cut a slit where my baby had attached to my left filopian tube, removed my baby, and tried to seal it together by burning it, but the bleeding wouldn't stop.  After a couple attempts to stop the bleeding, there was too much damage done to the tube, so they had to remove it.  My right filopian tube had twisted due to blood flowing into my stomach cavity and the surgeon suctioned out as much blood as possible.   Thankfully, both my ovaries are OK, my uterus looks healthy and they were able to untwist my right tube.  The surgeon recommends we try invitro to bypass another ectopic pregnancy in the future.

                                          ~~~~~~~~~~~~~~~~~~~~~~

God is healing me of this traumatic experience...it's slow, but it's happening.  Every time I go back to this memory scene, I feel saddness, pain, and hurt.  I have formed judgements about life and how I'm treated during difficult and traumatic experiences.  It's very easy to despair and fall into self-pity and woe is me when things go awfully wrong that are out of your control.  I invite Jesus into this memory scene and I see his hand on me that day and he was merciful and gracious.  The physical pain I felt was like none other.  I pulled at my hair just so I could focus on another part of my body.  Unfortunately, it didn't help.  I was crying out to God in my pain and anguish and told him that I wanted to die just so the pain would go away. My dad came over with 400 mg. of Motrin, I quickly ate something, swallowed the medicine, and within a minute the pain faded.  It was amazing!  A medicine never worked that quickly before to rid me of my cramps and the resident doctor confirmed the dosage wasn't enough to ward off the pain of an ectopic, but it did for me because Jesus took away my distress. Jesus intervened and spared me from prolonged physical suffering.   I waited for James to come home from work and he took me to the ER. I was physically without pain the entire evening.  Jesus grieved during my surgery because he hates death and said, "It is finished".  My baby was removed and it was over. God gave me a special gift for my birthday...to play with my kids in heaven!  As the nurses were waking me up from surgery and though it was difficult to speak, I had to share the good news that my kids are in heaven and I got to know them.  I have hope because I know where they are and I'll be there some day to spend eternity with them and my heavenly father.  

Monday, August 22, 2011

Uncontrollable tears

I went to church this morning at New Life Dresher and sat towards the front of the sanctuary.   Pastor John Gullett spoke about A Kingdom that can't be Shaken.  It isn't posted yet on the church website, but it will be.  Why the tears?  I'm sad, discouraged, and lack faith. I've been wresting with identity issues, fear, and haven't accepted the cup that's been handed to me.  Bottom line is that I've been  questioning God's love for me lately.  I know the truth, but my heart is constantly doubting.  I identify with "Doubting Thomas" who needed to see the marks on Jesus' resurrected hands and a "Sinking Peter" who walked on water with Jesus.   

I didn't take notes today because I felt like I just needed to listen and a few things resonated.  The sermon is from Hebrews 12:18, The Mountain of Fear and the Mountain of Joy.  The pastor of Hebrews is writing his people who want to go back to their old ways and convert back to Judaism.  The message is to remind the readers that what they have NOW is far better than anything they had before Christ.  He warned them not to trust or pursue things that can be shaken, but to focus on the ONE who is not shakeable.  Deep!  The question posed to the congregation at New Life was, "What are the ultimates in my life?"... my treasures, my non-negotiables.  I find my ultimates in all of the above!  I find my identity in work, family, and children.  I have been shaken to the core by my infertility, losses, and ongoing grief so much that I wanted to wail in church this morning.  I felt like Hannah who was praying at church because her womb was closed and Eli, the priest, thought she was drunk because in her deep anguish she was weeping bitterly.   That's me!  I kept it together, but it was HARD because the truth of the gospel was literally cutting my heart so much that my body began to shake.  After the sermon, John came by and gave me a hug.  I thanked him for the sermon and said I was embarrassed for crying so much during his sermon.  John shared that he cried too, yesterday, and that was comforting.   The truth of the gospel will produce the fruit of tears. 
James and I usually go out to lunch with our friends after church, but I had to go home so I could process some more and let it all out to the Lord without restaint.  I was free to cry in the comforts of home, we talked about the sermon, and James prayed for me.  There are no words to express the pain I feel and I'm thankful that my husband intercedes for me when he prays.  James verbalizes what I can't when I despair.  The Ahns wept, Jesus collected our tears, and we're comforted once again.   It's such a process. 
We press on in faith and keep moving forward despite the obstacles.  God isn't disappointed with me when I doubt him.  It doesn't mean that I don't know him.  He can handle any doubt.  He wants me to have faith in him...faith even as small as a mustard seed.

"One of the facets of a sound Christian faith is to level with God about your doubts or disbelief, your lack of wisdom or strength.  God can withstand tough, honest prayers.  I try to face my doubts and fears forcefully with confidence that God will forgive me."  - Former President Jimmy Carter



Friday, August 19, 2011

Infertility Etiquette

I'm coming across some online resources about infertility.  Below is an article from Resolve, The National Infertility Association.  It's a good read and summarizes most of my interactions with some well meaning friends in my life.  If I disagree with something in an article, the comment or opinion will have a strikethrough.  

Chances are, you know someone who is struggling with infertility. More than seven million people of childbearing age in the United States experience infertility. Yet, as a society, we are woefully uninformed about how to best provide emotional support for our loved ones during this painful time.
Infertility is, indeed, a very painful struggle. The pain is similar to the grief over losing a loved one, but it is unique because it is a recurring grief. When a loved one dies, he isn't coming back. There is no hope that he will come back from the dead. You must work through the stages of grief, accept that you will never see this person again, and move on with your life.
The grief of infertility is not so cut and dry. Infertile people grieve the loss of the baby that they may never know. They grieve the loss of that baby who would have had mommy's nose and daddy's eyes. But, each month, there is the hope that maybe that baby will be conceived after all. No matter how hard they try to prepare themselves for bad news, they still hope that this month will be different. Then, the bad news comes again, and the grief washes over the infertile couple anew. This process happens month after month, year after year. It is like having a deep cut that keeps getting opened right when it starts to heal.
As the couple moves into infertility treatments, the pain increases while the bank account depletes. The tests are invasive and embarrassing to both parties, and you feel like the doctor has taken over your bedroom. And for all of this discomfort, you pay a lot of money.
A couple will eventually resolve the infertility problem in one of three ways:
  • They will eventually conceive a baby.
  • They will stop the infertility treatments and choose to live without children.
  • They will find an alternative way to parent, such as by adopting a child or becoming a foster parent.
Reaching a resolution can take years, so your infertile loved ones need your emotional support during this journey. Most people don't know what to say, so they wind up saying the wrong thing, which only makes the journey so much harder for their loved ones. Knowing what not to say is half of the battle to providing support.
Don't Tell Them to Relax
Everyone knows someone who had trouble conceiving but then finally became pregnant once she "relaxed." Couples who are able to conceive after a few months of "relaxing" are not infertile. By definition, a couple is not diagnosed as "infertile" until they have tried unsuccessfully to become pregnant for a full year. In fact, most infertility specialists will not treat a couple for infertility until they have tried to become pregnant for a year. This year weeds out the people who aren't infertile but just need to "relax." Those that remain are truly infertile.
Comments such as "just relax" or "try going on a cruise" create even more stress for the infertile couple, particularly the woman. The woman feels like she is doing something wrong when, in fact, there is a good chance that there is a physical problem preventing her from becoming pregnant.
These comments can also reach the point of absurdity. As a couple, my husband and I underwent two surgeries, numerous inseminations, hormone treatments, and four years of poking and prodding by doctors. Yet, people still continued to say things like, "If you just relaxed on a cruise . . ." Infertility is a diagnosable medical problem that must be treated by a doctor, and even with treatment, many couples will NEVER successfully conceive a child. Relaxation itself does not cure medical infertility.
Don't Minimize the Problem
Failure to conceive a baby is a very painful journey. Infertile couples are surrounded by families with children. These couples watch their friends give birth to two or three children, and they watch those children grow while the couple goes home to the silence of an empty house. These couples see all of the joy that a child brings into someone's life, and they feel the emptiness of not being able to experience the same joy.
Comments like, "Just enjoy being able to sleep late . . . .travel . . etc.," do not offer comfort. Instead, these comments make infertile people feel like you are minimizing their pain. You wouldn't tell somebody whose parent just died to be thankful that he no longer has to buy Father's Day or Mother's Day cards. Losing that one obligation doesn't even begin to compensate for the incredible loss of losing a parent. In the same vein, being able to sleep late or travel does not provide comfort to somebody who desperately wants a child.
Don't Say There Are Worse Things That Could Happen
Along the same lines, don't tell your friend that there are worse things that she could be going through. Who is the final authority on what is the "worst" thing that could happen to someone? Is it going through a divorce? Watching a loved one die? Getting raped? Losing a job?
Different people react to different life experiences in different ways. To someone who has trained his whole life for the Olympics, the "worst" thing might be experiencing an injury the week before the event. To someone who has walked away from her career to become a stay-at-home wife for 40 years, watching her husband leave her for a younger woman might be the "worst" thing. And, to a woman whose sole goal in life has been to love and nurture a child, infertility may indeed be the "worst" thing that could happen.
People wouldn't dream of telling someone whose parent just died, "It could be worse: both of your parents could be dead." Such a comment would be considered cruel rather than comforting. In the same vein, don't tell your friend that she could be going through worse things than infertility.
Don't Say They Aren't Meant to Be Parents
One of the cruelest things anyone ever said to me is, "Maybe God doesn't intend for you to be a mother." How incredibly insensitive to imply that I would be such a bad mother that God felt the need to divinely sterilize me. If God were in the business of divinely sterilizing women, don't you think he would prevent the pregnancies that end in abortions? Or wouldn't he sterilize the women who wind up neglecting and abusing their children? Even if you aren't religious, the "maybe it's not meant to be" comments are not comforting. Infertility is a medical condition, not a punishment from God or Mother Nature.
Don't Ask Why They Aren't Trying IVF
In vitro fertilization (IVF) is a method in which the woman harvests multiple eggs, which are then combined with the man's sperm in a petri dish. This is the method that can produce multiple births. People frequently ask, "Why don't you just try IVF?" in the same casual tone they would use to ask, "Why don't you try shopping at another store?"
Don't Be Crude
It is appalling that I even have to include this paragraph, but some of you need to hear this-Don't make crude jokes about your friend's vulnerable position. Crude comments like "I'll donate the sperm" or "Make sure the doctor uses your sperm for the insemination" are not funny, and they only irritate your friends.
Don't Complain About Your Pregnancy
This message is for pregnant women-Just being around you is painful for your infertile friends. Seeing your belly grow is a constant reminder of what your infertile friend cannot have. Unless an infertile women plans to spend her life in a cave, she has to find a way to interact with pregnant women. However, there are things you can do as her friend to make it easier.
The number one rule is DON'T COMPLAIN ABOUT YOUR PREGNANCY. I understand from my friends that, when you are pregnant, your hormones are going crazy and you experience a lot of discomfort, such as queasiness, stretch marks, and fatigue. You have every right to vent about the discomforts to any one else in your life, but don't put your infertile friend in the position of comforting you.
Your infertile friend would give anything to experience the discomforts you are enduring because those discomforts come from a baby growing inside of you. When I heard a pregnant woman complain about morning sickness, I would think, "I'd gladly throw up for nine straight months if it meant I could have a baby." When a pregnant woman would complain about her weight gain, I would think, "I would cut off my arm if I could be in your shoes."
I managed to go to baby showers and hospitals to welcome my friends' new babies, but it was hard. Without exception, it was hard. Stay sensitive to your infertile friend's emotions, and give her the leeway that she needs to be happy for you while she cries for herself. If she can't bring herself to hold your new baby, give her time. She isn't rejecting you or your new baby; she is just trying to work her way through her pain to show sincere joy for you. The fact that she is willing to endure such pain in order to celebrate your new baby with you speaks volumes about how much your friendship means to her.
Don't Treat Them Like They Are Ignorant
For some reason, some people seem to think that infertility causes a person to become unrealistic about the responsibilities of parenthood. I don't follow the logic, but several people told me that I wouldn't ache for a baby so much if I appreciated how much responsibility was involved in parenting.
Let's face it-no one can fully appreciate the responsibilities involved in parenting until they are, themselves, parents. That is true whether you successfully conceived after one month or after 10 years. The length of time you spend waiting for that baby does not factor in to your appreciation of responsibility. If anything, people who have been trying to become pregnant longer have had more time to think about those responsibilities. They have also probably been around lots of babies as their friends started their families.
Perhaps part of what fuels this perception is that infertile couples have a longer time to "dream" about what being a parent will be like. Like every other couple, we have our fantasies-my child will sleep through the night, would never have a tantrum in public, and will always eat his vegetables. Let us have our fantasies. Those fantasies are some of the few parent-to-be perks that we have-let us have them. You can give us your knowing looks when we discover the truth later.
Don't Gossip About Your Friend's Condition
Infertility treatments are very private and embarrassing, which is why many couples choose to undergo these treatments in secret. Men especially are very sensitive to letting people know about infertility testing, such as sperm counts. Gossiping about infertility is not usually done in a malicious manner. The gossipers are usually well-meaning people who are only trying to find out more about infertility so they can help their loved ones.
Regardless of why you are sharing this information with someone else, it hurts and embarrasses your friend to find out that Madge the bank teller knows what your husband's sperm count is and when your next period is expected. Infertility is something that should be kept as private as your friend wants to keep it. Respect your friend's privacy, and don't share any information that your friend hasn't authorized.
Don't Push Adoption (Yet)
Adoption is a wonderful way for infertile people to become parents. (As an adoptive parent, I can fully vouch for this!!) However, the couple needs to work through many issues before they will be ready to make an adoption decision. Before they can make the decision to love a "stranger's baby," they must first grieve the loss of that baby with Daddy's eyes and Mommy's nose. Adoption social workers recognize the importance of the grieving process. When my husband and I went for our initial adoption interview, we expected the first question to be, "Why do you want to adopt a baby?" Instead, the question was, "Have you grieved the loss of your biological child yet?" Our social worker emphasized how important it is to shut one door before you open another.
You do, indeed, need to grieve this loss before you are ready to start the adoption process. The adoption process is very long and expensive, and it is not an easy road. So, the couple needs to be very sure that they can let go of the hope of a biological child and that they can love an adopted baby. This takes time, and some couples are never able to reach this point. If your friend cannot love a baby that isn't her "own," then adoption isn't the right decision for her, and it is certainly not what is best for the baby.
Mentioning adoption in passing can be a comfort to some couples. (The only words that ever offered me comfort were from my sister, who said, "Whether through pregnancy or adoption, you will be a mother one day.") However, "pushing" the issue can frustrate your friend. So, mention the idea in passing if it seems appropriate, and then drop it. When your friend is ready to talk about adoption, she will raise the issue herself.
So, what can you say to your infertile friends? Unless you say "I am giving you this baby," there is nothing you can say that will erase their pain. So, take that pressure off of yourself. It isn't your job to erase their pain, but there is a lot you can do to lesson the load. Here are a few ideas.
Let Them Know That You Care
The best thing you can do is let your infertile friends know that you care. Send them cards. Let them cry on your shoulder. If they are religious, let them know you are praying for them. Offer the same support you would offer a friend who has lost a loved one. Just knowing they can count on you to be there for them lightens the load and lets them know that they aren't going through this alone.
Remember Them on Mother's Day
With all of the activity on Mother's Day, people tend to forget about women who cannot become mothers. Mother's Day is an incredibly painful time for infertile women. You cannot get away from it-There are ads on the TV, posters at the stores, church sermons devoted to celebrating motherhood, and all of the plans for celebrating with your own mother and mother-in-law.
Mother's Day is an important celebration and one that I relish now that I am a mother. However, it was very painful while I was waiting for my baby. Remember your infertile friends on Mother's Day, and send them a card to let them know you are thinking of them. They will appreciate knowing that you haven't "forgotten" them.
Support Their Decision to Stop Treatments
No couple can endure infertility treatments forever. At some point, they will stop. This is an agonizing decision to make, and it involves even more grief. Even if the couple chooses to adopt a baby, they must still first grieve the loss of that baby who would have had mommy's nose and daddy's eyes.
Once the couple has made the decision to stop treatments, support their decision. Don't encourage them to try again, and don't discourage them from adopting, if that is their choice. Once the couple has reached resolution (whether to live without children, adopt a child, or become foster parents), they can finally put that chapter of their lives behind them. Don't try to open that chapter again.

Sono

This morning, I had my sonohysterography at 10am at Dr. M's office. A sono looks inside the uterus cavity to determine if it's a healthy home to grow a baby.  The ultrasound tech started with a baseline ultrasound to look at the lining of my uterus.  She looked around and said she couldn't find my left fillopian tube.  I said, "Oh, yeah...that was removed"  and she asked if I had an ectopic.  I replied, "Yes" and she asked when it happened.  I answered, "in April and on my birthday".  This is the first time, since the ectopic, I'm reminded of my missing body part.  I know my left tube is completely removed, but I still feel like it's still there until someone reminds me of the truth.  It's weird.  I can't explain it. Oh, that's right...it's called denial. 

The tech asked me if a resident could perform my sono and I was hesitant because I had an awful experience with a resident at Abington the night of my ectopic.  Plus, I don't appreciate being a guiney pig with everything I've been through, but I know students learn by practicing.  The tech reasurred me that she's done this many times before and she's good at it, so I complied.  Dr. M and resident walked in and to my relief, it was the resident who gave me the mini-bio lesson during our IVF consult!  I trust my doctor and I liked the resident, but didn't trust her yet.  Dr. M was chatting with me while the resident put the speculum in.  After a while, I couldn't talk anymore because I was getting tense and anxious about the upcoming pain.  I decided to close my eyes and do some deep breathing, which helped me to relax my body.  In the meantime, my cervix was cleansed and the iodine solution was injected into the cavity of my uterus.  The iodine caused some mild cramping and am thankful the pain wasn't as intense in comparison to the HSG x-ray.  Taking 2 midol an hour before the procedure helped too!  Next, with a smaller speculum, the resident did a practice run of the catheter pass  to make sure that Dr. M will be able to insert our 2 embryos into my uterus without a hitch.  It went smoothly.  The good news is the lining of my uterus looks healthy and I'm relieved.  Dr. M decided to take a look at my ovaries and for the first time I saw the cysts surrounding my ovaries on the ultrasound TV.  I certainly have PCOS.

I'm thankful the pain was bearable and not painful.  Thanks SR for driving me to my appointment and for being there. 

The cost: $50 copay















Wednesday, August 10, 2011

IVF Orientation

This morning I drove an hour to Reading to meet with my nurse, D.  She started to explain the steps I need to go through and quickly felt overwhelmed with all the information and wished that James was with me.  D started off by telling me that I need to start the pill on Thursday.  What a surprise since I'm trying to get pregnant!  Due to my long cycle, my ovulation is sporatic and difficult to predict so the pill will help. By the end of this week, I need to decide on a pharmacy for D to order my drugs.  In addition to taking the pill, my body will be injected with Luprone (thigh), Follistem (stomach), Repronex (behind), HCG (behind), and Progesterone shots (behind).  One word: DREAD.  I'm dreading all these shots!  Keeping track of my meds, timing my injections, rotating my shot placements, burning sensations, marks, and the side effects of Luprone start in 2 weeks.  I'm purchasing a calendar with lots of space to write so I can keep track of it all.  Before I left, D went over all the consent forms James and I need to sign and suggested I get my blood drawn today or next Thursday when I have my Sono since Quest doesn't administer the type I need.  I opted to get it over with and had it done before I left.  Not a good choice because according to my standards, I didn't drink enough water in the morning and feared the phlebotomist wouldn't be able to find a vein or that nothing would come out.  The phlebotomist  had a student with her and she found a vein, but would quickly loose it.  I was a little nervous and was hoping she'd do a good job.  The student poked me on my right arm with no success.  The phlebotomist had a try, found a vein, poked me on my left arm, did lots of digging and I asked her to stop because it hurt.  The phlebotomist tried again on my right arm, did some digging, and got blood!  The combination of having to use a big needle and possibly not drinking enough water made it a bad experience.  I got home an hour later, cried, and took a little nap.  I was exhausted. 
Why is having a baby so complicated and hard?  It wasn't meant to be this way.  It's not what God intended.  God desires fertility among men and women so we can bear fruit and multiply, but we live in a fallen world and one of its many consequences is the dreaded word, infertility. 
Despite my morning, I'm remembering to count my blessings and we're blessed to be able to afford IVF and everything else that comes with it.   

The cost: free



Sunday, August 7, 2011

First month of preparation begins

Today marks the start of my preparation for IVF.  I'll have to get an AMH (Anti-Mullerian Hormone) test, a SHG (sonohystogram), and PFA (platelet function assay) test this week.  The AMH bloodwork will reveal my ovarian function, remaining egg supply, and predicts my success rate with IVF.  Pray for high AMH levels, which increases the number of eggs retrieved with the fertiity drugs.  The SHG is an ultrasound to check the health of my uterus.  I'll experience some cramping and my doctor will do a catheter pass as a test run to make sure things run smoothly the day of the drop.  The PFA is needed to see if I have blood clotting issues which would interfere with implementation (attaching) to the uterus. 

The process of getting poked and prodded is about to begin all over again and I'm tired after 4 years of TTC (trying to conceive).  "When I am weak, He is strong."  I need his strength and his strong arms around me as we go through this process.  We covet your prayers!

Saturday, August 6, 2011

Invitro

After multiple losses and a ruptured ectopic pregnancy, the path of least resistance is invitro.  I can get pregnant and have 5 times, but my embryos don't implant (attach) to my uterus. Since I've experienced 1 ectopic already, my chances have increased for another one and I never want to go through that again if I can help it.  I'll write about my tubal pregnancy on a later post.  

Our 4, going on 5 years of TTC (trying to conceive) has been a long and bumpy roller-coaster ride and we're not exiting just yet.  James and I went to our invitro consult a few weeks ago and experienced major information overload.  I got a mini-biology lesson since science was never a strength, listened carefully to the cost breakdown, and paid attention to the medications I'd have to take/administer. 


The process is starting all over again and the bottom line is that I am scared of another disappointment.   I'm trying to be hopeful in times of uncertainty and trusting in the Lord regardless of the outcome.